- Avoid Processing Delays by Following Proper Submission Guidelines
- Medicare Beneficiary Eligibility Checklist
- Acceptable Electronic Signatures Reminder
- Capable Recipients for the Advance Beneficiary Notice of Noncoverage
- Hospital-Issued Notices of Noncoverage
- Medicare Advance Written Notices of Noncoverage Booklet
- Primary Care Exception Guidelines
- Ordering DMEPOS Items
- Appropriate Use Criteria Program
- Assistant at Surgery Billing Documentation Reminder
- Avoid Return to Provider and Claim Rejections-Enhancing the Beneficiary Eligibility Verification Process
- Checking Eligibility and Knowing Your Point of Contact
- Cloned Documentation Could Result in Medicare Denials for Payment
- Documentation Reminder: Psychiatry and Psychology Services
- Documentation Required for Home Visits
- Electrical Stimulation Therapy: Important Coverage and Documentation Reminders
- Go Paperless Today - Protect Your Bottom Line
- Hospital Acquired Conditions and Present on Admission Resource for Physicians
- Inpatient Admission Prior to Medicare Entitlement Job Aid
- MDS Calendar
- Medicare Home Health Collaboration with Other Provider Types
- Part A Claims for High Cost Items and Certain Drugs Requiring Additional Information
- Manual Review of Claims for Replacement of Supplies and Accessories used with External Ventricular Assist Device
- Referring, Monitoring and Certifying Home Health Services
- Scribing Medical Record Documentation
- Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet
- Submit Medical Record Documentation Electronically
- Submitting Electronic Medical Records via CD-ROM
- Using the Medicare Part B PWK Fax-Mail-esMD Cover Sheet
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders
Table of Contents
CPT/HCPCS: 97032
National Government Services, Inc. conducts prepayment reviews on claims for CPT code 97032, electrical stimulation (manual) (to one or more areas), each 15 minutes. After reviewing the records that were submitted in response to an ADR, many claim denials were issued for missing documentation to support direct (one-on-one) contact. Based on these findings, we are providing information regarding the documentation requirements for electrical stimulation therapy services.
Coverage and Documentation
It’s important to note that CPT code 97032 is a constant attendance electrical stimulation modality that requires direct (one-on-one) manual patient contact by the qualified professional/auxiliary personnel. Because the use of a constant, direct contact electrical stimulation modality is less frequent, documentation must clearly describe the type of electrical stimulation provided, as well as the medical necessity of the constant contact to justify billing 97032 versus G0283.
HCPCS code G0283 - Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care is classified as a “supervised” modality, even though it is labeled as “unattended”. If providing an electrical stimulation modality that is typically considered supervised (G0283) to a patient requiring constant attendance for safety reasons due to cognitive deficits, you should not bill as 97032. A supervised modality does not require direct (one-on-one) patient contact by the provider and may be done by nonskilled personnel.
In addition to missing documentation to support direct (one-on-one) contact, below are examples of documentation that was also missing:
- Therapy notes
- Physical therapy initial evaluation with treatment plan
- Interim progress notes
- Updated evaluations with physician signed treatment plans as applicable
- Modality minutes logs
- Signed physician’s orders
Provider Actions
- Share this information with the appropriate departments who may be involved in ordering, providing, billing or reviewing medical records and documentation for these types of services
- Update any internal procedures or policies with the information in this article and in the associated referenced resources.